Transgender Americans take on New York


Joann Prinzivalli says she believes a person's sexual identity is determined by their mind rather than their genitals

A group of transgender men and women want New York City to make it easier to change the "M" or "F" on their birth certificates. What makes a man or a woman, and why do governments care?

In the annals of unhappy encounters with driving licence authority officials, Patricia Harrington's and Joann Prinzivalli's seem particularly miserable.

Both had been living as women for years, but still carried birth certificates showing the sex they were designated at birth - male.

Ms Harrington, who was hoping to transfer her New York state driving licence to the state of New Jersey, was told to return with a doctor's note.

"It just made me furious," says Ms Harrington.

"I would just like to get a corrected birth certificate that identifies me, so that when I have to show it for identification I don't automatically become some kind of criminal suspect."

'It's personal'

New York City, where both were born, will amend a person's birth certificate to reflect a sex change, but only if the person has undergone "convertive surgery" on the genitals.

A detail from Joann Prinzivalli's birth certificate Joann Prinzivalli's birth certificate lists her as male; She says she is female

In practice, transgender people say, that means turning penises into vaginas or vice versa, and Ms Harrington is content to keep the male bits she was born with.

"It's personal, it's my privates, it's not necessary. It's a very expensive procedure which I can't afford, and it's got complications. I'm not sexually active. If I was 21 and I could afford it, yeah, but I'm 59."

Last year, Ms Harrington, Ms Prinzivalli and another transgender person sued the city of New York to force it to relax its birth certificate change requirements.

The suit is part of a quiet movement across the US and beyond to bring the rules governing identity documents into line with what transgender advocates describe as advances in the understanding of sex classification.

It is the contents of a person's mind and soul, they say, which determine sex - not what is inside their pants.

"Recognition of our gender is really a matter of basic human dignity," says Masen Davis, executive director of the Transgender Law Center in San Francisco.

"Transgender people - like all of us - deserve to live with dignity and respect. Having something as simple as government recognition of our authentic gender identity goes a long way in promoting health, wellness and safety."

Roadblocks and harassment

In the US, birth certificates can be required to apply for public benefits like food stamps and healthcare, for professional certification, to register for school, to marry, to prove employment eligibility, and in other circumstances.

Start Quote

People don't just change their [gender] role not knowing whether they're going to like it or not. It's not a casual decision”

End Quote Walter Bockting Psychologist

Transgender Americans have complained of bureaucratic roadblocks and harassment when they produce a birth certificate that lists a sex different from the one they are living.

In interviews with transgender individuals, motor vehicle clerks seem especially unforgiving.

"When I showed them the birth certificate, the clerk behind the counter changed her demeanour and very loudly referred to me as 'sir' and 'this gentleman'," says Ms Prinzivalli, who has lived as a woman for more than a decade.

"It was a mortifying experience. I'm being stripped of my identity by some [motor vehicle] clerk that I have to treat respectfully. It took me days to start crawling back up out of the little hole I dug myself."

Success in California

The issue at stake in New York and elsewhere - both inside the US and overseas - is not whether transgender people should be allowed to amend identity documents (only a US handful of states forbid a birth certificate change outright).

Instead the debate centres on where officials draw the line between male and female.

Patricia Harrington Harrington needed to show her 'male' birth certificate when she moved house

The US government and many US states, as well as the UK and Australia, have done away with the requirement for surgery to convert the genitals. That is partly in response to transgender activists who say the requirement was based on an obsolete understanding of sexual identity.

In 2011 the Transgender Law Center successfully pushed for passage of legislation ending surgery as a requirement to obtain a new birth certificate in California.

In September, Australia began allowing transgender individuals to change the sex on their passports without having to undergo sex reassignment surgery; in October the nation's highest court gave legal recognition to two transgender men who had not had sex-change surgery.

Under the 2004 Gender Recognition Act, the UK does not require genital surgery before allowing individuals to obtain official recognition of their new gender.

And in 2010, the US State Department issued new guidelines requiring only "appropriate clinical treatment" to obtain a new passport or a birth certificate for US citizens born outside the country.

New York refuses

New York City's board of health and mental hygiene has resisted pressure to change its birth certificate policy.

In a 2006 ruling the board cited potential impacts on hospitals, schools and jails, and opted to maintain the genital surgery requirement.

So last year, Ms Harrington, Ms Prinzivalli and a transgender man who was designated female at birth sued the city.

The city has sought to have the suit dismissed, arguing that sex as recorded on the birth certificate refers to biological and physical characteristics like the nature of the genitals, while the lived experience of socially constructed roles are gender, a separate category.

"The utilisation of sex as a classification method is rational, since it is a straight forward way to ensure that birth records in the City of New York are uniform," lawyers for the city wrote in a court filing.

"The standard leaves little room for individual interpretation. By simply looking at a baby's genitalia, an individual is able to determine its sex."

The city says if it were to allow an individual like Ms Prinzivalli to obtain a new birth certificate with the different sex, it would be "knowingly issuing a false public record".

Transgender individuals and their advocates say the city's conception of sex is outdated and inappropriately narrow.

However, officials for the New York City department of health and mental hygiene did not respond to a request for comment.

Oral arguments in the case are scheduled for next month.

Permanent change

Genital surgery is complicated, risky, invasive and entails a long period of recovery, and the vast majority of transgender individuals have not undergone it. The procedures are also expensive and out of reach for many.

Only about 20% of male-to-female transgender people have had genital reconstruction surgery, and only about 5% of female-to-male, estimates Walter Bockting, a psychologist at the University of Minnesota medical school who has 20 years of clinical experience working with transgender patients.

Dr Bockting says a more appropriate standard for new identity documents would be evidence the role change is permanent and medically necessary to relieve the stress would-be transgender people experience from the conflict between their gender identity and their birth sex.

"People don't just change their role not knowing whether they're going to like it or not," Mr Bockting says. "It's not a casual decision."

Some, like Joanne Prinzivalli - whose birth certificate still lists her as Paul and as male - are medically precluded from the surgery.

Nick Gorton, an emergency room doctor who has lived as a man for about nine years and who says he has "perfect passing privilege" without genital surgery, ridicules governments' insistence that sex depends on what is between the legs.

"Let's say if a woman gets a really bad cancer and has to have a hysterectomy or a vaginectomy. Does she have to change her gender marker?"


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  • rate this

    Comment number 295.

    Your DNA says your sex and it is permanent. Legal and medical documents must be correct and NOT reflect your mental state. If you have emotional issues address your points of trouble not the facts. The birth records are used for ancestry work and will be more important as science advances. A free state ID should eliminate any need to publicly disclose your birth certificate; focus on THAT instead.

  • rate this

    Comment number 294.

    @lhe Washington state does change the gender marker on driver's licences prior to surgery if someone is diagnosed with GID and is transitioning.
    @plumedenom "These men" are women. That's why they are classified as trans. Some do not appear as female as they would like (and nor do some women) but that isn't the point. Their brain is female, but they have to live with the body they were born with.

  • rate this

    Comment number 293.


    Women have penises, too! Start developing a concept of that.

    What they are advocating for is sensible and fair. As the transgender women above, I am happy with my point of transition, as a preop. I do not identify my genitals (sex) with my gender. Why should I have to go through an unneeded surgery, to have the correct legal bearing on my birth certificate? Dissolve any barriers...

  • rate this

    Comment number 292.

    I think New York has it about right. These two people were born male and still retain male genitalia. If they were hospitalised and required surgery, it would be for a male person not a female. Ms Harrington says "It's personal, it's my privates, it's not necessary." But government is interested in facts not states of mind when it comes to sexual identity.

  • rate this

    Comment number 291.

    It would seem that, beyond the paperwork, more needs to be done to ensure public officials have greater empathy with their clientele and a less discriminatory reaction to those who lead lives different to theirs.

  • rate this

    Comment number 290.

    The root cause of the issues transgender men and women face will not be resolved by changing their birth certificates. It may make getting passports and other documents easier but it's surely the attitude towards and/or lack of recognition of transgenderism that is the issue here? This requires a bigger change in attitudes across society.

  • rate this

    Comment number 289.

    Again, the only reason given as to why someone needs to know someones gender,other than in a possible medical setting, is insurance!

    Bit unfair on sensible blokes out there.

    Hmm,wonder what discrimination law says ?

    Or maybe we are all just numbers after all ?

  • rate this

    Comment number 288.

    Drivers licenses and birth certificates, at least in my state (WA), identify sex, not gender. Sex is biological (whereas gender is a mental/social construct), and until one's sex has been altered through surgery, it would be inaccurate to revise the sex listed on such documents. I fully support transgender equality, but this is a matter of practicality and accuracy.

  • Comment number 287.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 286.

    Do these men really think they appear female?

  • rate this

    Comment number 285.

    Your comment is ridiculous, I'm a 21 year old pre-op tgirl, if I don't tell people I'm TS then they have no idea. I live as any normal female, my passport/drivers license says female, yet my BC still says male when I will never live as a male.
    Bringing sexuality into this conversation shows how narrow-minded you are, because quite frankly they have nothing to do with one another!

  • rate this

    Comment number 284.

    @voiceofreason Unlike the impression given by the media, trans people don't try and "trick" others into sleeping with them. Apart from anything else, it could lead to being severely beaten or killed. Of course it isn't something people would necessarily mention on a first date, since trust would have to be established first, and certainly before sleeping with someone.

  • rate this

    Comment number 283.

    @PlayingTheDevilsAvocado You raise a good point. It is sometimes referred to as "birth assigned gender", since the medical staff take a look between your legs and assign a gender. They can't currently look at your brain physical structure or genes and spot that your assigned gender is wrong. ID needs to be gender neutral, e.g. fingerprints. It is all that common to change gender multiple times.

  • rate this

    Comment number 282.

    The problem that worries me is seeing a boyish girl or a girlish man wearing unisex clothing. I cannot tell whether they are M or F and foresee that an embarrassing problem might arise. Other embarrassing situations have been discovering a female parts person when one wishes to buy "greasers". "Oh you mean NIPPLES" the parts lady said! Glad she had a sense of humour.

  • rate this

    Comment number 281.

    An opportunity to become a transgender without changing the genitals is very interesting. One may be a woman for those to whom she shows her documents, and a man for those to whom he shows another kind of proof. Always ask for ID card or passport before deciding who is that person before you! Also, with this, someone may become homosexual without even suspecting it!

  • rate this

    Comment number 280.

    @249 There are no mistakes with the birth certificate. It indicates the physical gender of the person at the time of their birth. Whatever someone does later life to their sex doesn't mean that they changed the sex that they were born as.

    The problem is that birth certificates are used as ID.

    Why does someone's sex matter? Male and female bodies are different and so is the insurance risk.

  • rate this

    Comment number 279.

    Slow news day? Apart from the New York Centric angle? Nothing new here apart from a slick campaign. People been TG since we were people.

  • rate this

    Comment number 278.

    so how do you decide a gender identity at birth, its a birth certificate. I understand that this may be problematic later but that then comes down to what documentation is needed for your current identity. remember gender can also change over time, thats part of identity. so what should be used is identity cards but then thats another can o'worms.

  • rate this

    Comment number 277.

    Better yet, maybe we should stop listing one's gender altogether.

  • rate this

    Comment number 276.

    I think birth certificates should not be changed: they record a person's state at a point in time and later amendmends are not retrospective. But I entirely sympathise with TG people wanting their 'lived' gender recognised - so add a second certificate for them, with due legal safeguards and validity, so they no longer need to rely on the birth cert. Medical and social needs both satisfied.


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